The Role of the Vaginal Microbiome in Women’s Health and Disease

Dear Colleagues,

Chlamydia trachomatis and human papillomavirus (HPV), the most common pathogens of sexually transmitted infections (STIs), increase the risk of both cervical cancer (CC) and infertility. HPV is extremely common worldwide; scientists distinguish between low-risk and high-risk genotypes, and transmission can take place via simple contact in the genital area. A total of 50 to 80% of sexually active individuals become infected with both C trachomatis and HPV viruses during their lifetime and up to 50% become infected with an HPV oncogenic genotype. The natural history of co-infection is strongly conditioned by the balance between the host microbiome and immune condition and the infecting agent. Though the infection often regresses, it tends to persist asymptomatically throughout adult life. The partnership between HPV and the C trachomatis occurs due to their similarities; they share common transmission routes, reciprocal advantages and the same risk factors. C trachomatis, as a Gram-negative bacterium, similarly to HPV, is an intracellular bacterium showing a unique biphasic development which helps it to steadily progress into the host throughout their life. Indeed, depending on the host’s immune condition, C trachomatis infection tends to migrate towards the upper genital tract and spreads to the uterus and fallopian tubes, opening the door for HPV invasion. In addition, most HPV and C trachomatis infections of the female genital tract are facilitated by the decay of the first line of defense in the vaginal environment constituted by a healthy vaginal microbiome characterized by a net equilibrium of all its components.

Medical microbiology, a large subset of microbiology that is applied to medicine, is a branch of medical science concerned with the prevention, diagnosis and treatment of infectious diseases, cancer and degenerative diseases. In addition, this field of science studies various clinical applications of microbes for improved health by enhancing immune responses at all levels. Thus, the aim of this Special Issue is to highlight the complexity and fragility of the vaginal microenvironment, accentuating the fundamental role of all elements and systems involved, including the Lactobacillus strains (Lactobacillus gasseri, Lactobacillus jensenii, Lactobacillus crispatus) and the role of the immune-endocrine system in preserving it from oncogenic mutation. Therefore, age, diet, genetic predisposition and condition of the immune system all impact the frequency and severity of disease, potentially resulting in precancerous and cancerous cervical lesions.

Prof. Dr. Raffaele Del Prete
Dr. Ciro Gargiulo Isacco
Guest Editors

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